APP-M-24-218486CITY OF DELRAY BENCH
HVAC: **ANYTHING OVER 5 TONS MAY REQUIRE FIRE EPT. REVIEW/APPROVAL**
KW
A.H.U. MODEL NO. & C/B SIZE TEM4AOC48S 30
C/B SIZE
BTUH CAPACITY 47000 S.E.E.R RATING 14.30 PACKAGE UNIT:
DUCT WORK: (Y) NO (N)
TOTAL PROJECT COST (LABOR AND MATERIAL): $ 12770.00
Before Rebates
C/U MODEL NO. & C/B SIZE 4A7A4048N1 0 X2
REFRIG. • lION
Equipment 41e:
C.U. Model No.:
H.P. or BTU/HR:
E.V,A.P. Model #:
Effic'y Rating:
PROJECT COST (LABOR AND MA
$
RIAL):
El
ADDITI AL DESCRI N LIKE FOR LIKE C/O OF (2) 4-TON SPLIT AC UNITS, NO ELECTRIC, NO DUCTING
CACO24382
64974 OR
SIGNATURE OF SUAL FIER CONTR. REGISTRATION # WORKERS COMP#
EXEMPT (FID /FEIN) #
STATE OF FLOIDA
COUNTY OF PALM BEACH t"POM AWN
The foregoing instrument was acknowledged before
this 15TH day of MAY
hysical presence or [] online notarization
WALTER WEISS. JR
Signature of Notary PuI,lic - State of Florida
/
I, I#4p ER to
Produced Identification
Type of Identification Produced REV 5/2023
100 NW jst Avenue Delray Beach FL 33444
(561) 243-7200 Fax: (561) 243-7221
Webs ite: www.delravbeachfl.qov
MECHANICAL PERMIT APPLICATION
(HVAC, REFRIGERATION, HOODS, SUPPRESSION)
FOR OFFICE USE ONLY:
PROPERTY CONTROL #: 12 - 43 ..46 - 07 - 00 - 000 - 5000
PLEASE PRINT: FILL IN COMPLETELY. INDICATE "N/A" WHERE APPLICABLE.
JOBSITE ADDRESS 850 N CONGRESS AVE (MAE VOLEN FACILITY)
PROPERTY OWNER NAME CITY OF DELRAY BEACH
HOME PHONE ( 561 ) 243 -7339 CELL
PROPERTY OWNER ADDRESS 100 NW 1ST AVE, DELRAY BCH, FL 33444
MECHANICAL CONT'R (COMPANY) NAME A-EXCELLENT SERVICE, INC
MECHANICAL CONT'R (COMPANY) ADDRESS 9121 N MILITARY IRL, STE 103
CITY PALM BEACH GARDENS ST FL ZIP 33410
BUS. PHONE( 561 ) 383-3855 CELL
E-MAIL aexcellentserv@aol.com FAX ( ) na
NOTE: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180-DAYS OR IF ACTIVITY LAPSES FOR 180 DAYS. PLANS
MUST BE ON THE JOB SITE FOR ALL INSPECTIONS. FINAL INSPECTION IS REQUIRED ON ALL PERMITS.
TYPE OF INSTALLATION - CHECK ALL THAT APPLY FOR THIS CONTRACTOR:
DESCRIPTION OF WORK: RESIDENTIAL
NEW IS THIS AN EXACT CHANGE-OUT?
xx COMMERCIAL xx REPLACEMENT YES NO
BLDG PERMIT #:
MECH PERMIT #:
PERMIT FEE:
PLAN CHECK FEE:
MCR#:
APPROVALS:
MECH: DATE:
PLAN: DATE:
FIRE: DATE:
INDICATE IF
SMOKE TEST IS REQUIRED
EJ HOODS - HAUST- BOOTH - BLOWER (2 SETS OF PLANS REQD)
Spray Booth:
Hoods:
SUPPRESSION SYSTEMS ( TS OF PLANS REQD)
Wet Chem: H
Clean Agent: Dry Che
PROJECT COST (LABOR AND MATERIAL):
$